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Montana rates for HCPCS 33697

Compl Rpr T-Fallot W/Pulm Atresia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,893.50 / $2,019.83 / $10,461.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,178.99 / $3,178.99 / $3,178.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,446.23 / $3,178.99 / $3,178.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,178.99 / $3,900.00 / $4,007.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,947.79 / $2,759.42 / $4,214.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,060.00 / $3,571.80 / $5,571.28